Classic homebirth screw-ups lead to yet another homebirth death


Another day, another baby who didn’t have to die at homebirth.

According to The Irish Times:

A couple who prepared for what they hoped would be an idyllic home birth by lighting candles and playing soothing sounds on their stereo ended up devastated when their baby was stillborn, an inquest heard today.

Too bad they thought candles and music constituted a perfect birth. Personally, I think a live, healthy baby makes a perfect birth and candles and music be damned.

What happened? The story follows the usual homebirth disaster script:

1. A long labor:

On May 23th, 2011, she awoke with abdominal cramps. Ms Engel arrived at about 11.30am. She again arrived at about 6pm and at about 10.30pm told her she could see “the top of the child’s head, his black hair”.

At around 12pm she said to the midwife that she felt it was taking too long, and just after 1am she said it again that she couldn’t get the baby out.

2. Lack of appropriate fetal monitoring and resulting in the “sudden” loss of the baby’s heartbeat:

The midwife told her to push harder but at about 1.30am the baby’s heartbeat had changed and she could not get a reading.

3. The father who insists that they should take the mother to the hospital.

… [H]er partner, suggested it was time she go to the hospital and the midwife agreed…

He said that at approximately 12.30am or 1am he turned off the music. The mood intensified. He saw and heard the baby’s heartbeat diminish and he had enough of what he was seeing and said straight out: “let’s go to the hospital”.

4.The failure to call an ambulance.

5. Delay in getting to the hospital:

However, the midwife’s car would not start and they had to transfer oxygen into her partner’s car. The three of them drove to the hospital in Mr Henaghan’s car.

By the time they got to the delivery suite it was 3am. Staff did an ultrasound on the baby and could not get a reading. The baby was stillborn at 3.23am.

6. The frantic attempts of hospital staff to resuscitate the baby, attempts that ultimately failed.

7. The midwife’s regrets:

[The mother] said that in the hospital immediately after it was clear that Kai had died, Ms Engel [the midwife] said she would never do a home birth again as long as she lived and kept saying “I am so sorry, I am so sorry.”

8. Failure to appropriately monitor the baby’s heart rate:

There was an “unfortunate absence” of foetal heart monitoring records in the medical notes.

9. The midwife changing her story and denying culpability:

In evidence today Ms Engel denied stating in the hospital after the stillbirth she would never do another home birth and also denied being reluctant to transfer her patient to hospital.

She also said she had carried out regular heartbeat checks during the attempted delivery and denied her car was unreliable, stating the problem starting it had been “transient”.

10. The classic exchange of the “birth experience” for the life of the baby:

[The father] said his girlfriend wanted to go down the route of having as natural a birth and pregnancy as possible and contacted Ms Engel, the only local midwife in Mayo. She only wanted to go to hospital if it meant the baby’s birth was at risk.

[He] said: “As part of Sarah’s natural birthing plans she had organised some music or sounds on the stereo to be played, some candles to be lit.

“Every aspect of the house was set out in the way she wanted it for the day of the birth.”

Too bad she didn’t worry more about the health of the baby, and less about an idyllic homebirth.